| NPI | 1710480827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501008855) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-958) |
| 225100000X Physical Therapist (Licence: FL PT31614) | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |